INTERNATIONAL OPEN UNIVERSITY

COMMUNITY SERVICE SUPERVISOR EVALUATION FORM

Student’s Name:

Student’s ID Number:

Type of Community
❑ Online Work ❑ Ground Work
Service:

Organization’s Name:

Supervisor’s Name:

Supervisor’s Email:

Country: City:

Starting Date: Ending Date:

Total Hours Worked:

Student’s Job Description:

________________________________________________________________________

Please grade the performance of the student in the following

categories: Excellent Very Good Good Fair Poor

Relation with Others:

Ability to Learn:

Quality of Work:
Additional Remarks:
__________________________________________________________________________
______________________________________________________

I, hereby, affirm that the work reported by the student in this form is a volunteer work.

Signature of Supervisor: Date: